title: Oxaliplapin and capecitabine (XELOX) based chemotherapy in the treatment of metastatic colorectal cancer: the right choice in elderly patients.
abstract: OBJECTIVE
  Elderly patients with metastatic colorectal cancer (mCRC) differ from the general population and are underrepresented in clinical trials. We, retrospectively, analyzed the safety and efficacy of XELOX regimen in the treatment of elderly patients affected by mCRC.
  
  
  METHODS
  One-hundred-eleven consecutive patients, aged 70 years or older, were enrolled in the study.
  
  
  RESULTS
  All patients were evaluated for safety and efficacy (male/female, 63/48). Median age was 75 years (range 71-85 years). Median Eastern Cooperative Oncology Group Performance Status (ECOG PS) was 0 (range 0-2). Metastatic sites distribution is as follows: liver (44.1%), lung (13.5%), liver plus lung (12.6%) and other (29.7%). A total of 584 cycles were administered (median 6 cycles/patient, range 2-10). Median follow-up time was 14.5 months (range 1-41 months). In an intent-to-treat analysis, objective responses and stable disease were recorded in 41 (40.4%) and 29 (26.6%) patients, respectively. The median response duration was 5.9 months (range 0.5-28.8). The median progression free-survival (PFS) was 7.5 months (range 1-26 months). The median overall survival (OS) was 15 months (range 1-64 months). The grade 3 toxicities were: neutropenia (8.1%), diarrhea and neurotoxicity (5.4% respectively). Most adverse events were mild to moderate; the most common was acute sensory neuropathy (57.6%).
  
  
  CONCLUSIONS
  XELOX is a highly effective first-line treatment for mCRC elderly patients. Response rates, PFS and OS are similar to those observed with fluorouracil/leucovorin/oxaliplatin combinations. XELOX is a convenient regimen, likely to be preferred by both patient and healthcare providers.
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN) Italy, Via Franco Gallini 2, 33081 Aviano (PN), Italy. mberretta@cro.it.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aprile
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Nasti
authors.forename: Martina
authors.initials: M
authors.lastname: Urbani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bearz
authors.forename: Stefania
authors.initials: S
authors.lastname: Lutrino
authors.forename: Luisa
authors.initials: L
authors.lastname: Foltran
authors.forename: Laura
authors.initials: L
authors.lastname: Ferrari
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiorica
authors.forename: Arben
authors.initials: A
authors.lastname: Lleshi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canzonieri
authors.forename: Chiara
authors.initials: C
authors.lastname: Lestuzzi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Borsatti
authors.forename: Rossella
authors.initials: R
authors.lastname: Fisichella
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000188:drug therapy; D010071:Oxaloacetates; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil